The impact of MEG results on surgical outcomes in patients with drug-resistant epilepsy associated with focal encephalomalacia: a single-center experience

2019 ◽  
Vol 267 (3) ◽  
pp. 812-822
Author(s):  
Xinghui He ◽  
Jian Zhou ◽  
Pengfei Teng ◽  
Xiongfei Wang ◽  
Yuguang Guan ◽  
...  
Keyword(s):  
Surgical Outcomes ◽  
Drug Resistant ◽  
Single Center ◽  
Single Center Experience ◽  
Drug Resistant Epilepsy ◽  
The Impact

scholarly journals Categorizing cortical dysplasia lesions for surgical outcome using network functional connectivity

2021 ◽  
pp. 1-9
Author(s):  
Abdullah S. Bdaiwi ◽  
Hansel M. Greiner ◽  
James Leach ◽  
Francesco T. Mangano ◽  
Mark W. DiFrancesco
Keyword(s):  
Functional Connectivity ◽  
Surgical Outcomes ◽  
Surgical Outcome ◽  
Network Connectivity ◽  
Cortical Dysplasia ◽  
Lesion Volume ◽  
Healthy Children ◽  
Drug Resistant ◽  
Drug Resistant Epilepsy ◽  
The Impact

OBJECTIVE Focal cortical dysplasia (FCD) is often associated with drug-resistant epilepsy, leading to a recommendation to surgically remove the seizure focus. Predicting outcome for resection of FCD is challenging, requiring a new approach. Lesion-symptom mapping is a powerful and broadly applicable method for linking neurological symptoms or outcomes to damage to particular brain regions. In this work, the authors applied lesion network mapping, an expansion of the traditional approach, to search for the association of lesion network connectivity with surgical outcomes. They hypothesized that connectivity of lesion volumes, preoperatively identified by MRI, would associate with seizure outcomes after surgery in a pediatric cohort with FCD. METHODS This retrospective study included 21 patients spanning the ages of 3 months to 17.7 years with FCD lesions who underwent surgery for drug-resistant epilepsy. The mean brain-wide functional connectivity map of each lesion volume was assessed across a database of resting-state functional MRI data from healthy children (spanning approximately 2.9 to 18.9 years old) compiled at the authors’ institution. Lesion connectivity maps were averaged across age and sex groupings from the database and matched to each patient. The authors sought to associate voxel-wise differences in these maps with subject-specific surgical outcome (seizure free vs persistent seizures). RESULTS Lesion volumes with persistent seizures after surgery tended to have stronger connectivity to attention and motor networks and weaker connectivity to the default mode network compared with lesion volumes with seizure-free surgical outcome. CONCLUSIONS Network connectivity–based lesion-outcome mapping may offer new insight for determining the impact of lesion volumes discerned according to both size and specific location. The results of this pilot study could be validated with a larger set of data, with the ultimate goal of allowing examination of lesions in patients with FCD and predicting their surgical outcomes.

scholarly journals Impact of Tocilizumab on Clinical Outcomes in COVID-19-Associated Cytokine Release Syndrome: A Single-Center Experience

2021 ◽  
pp. 089719002110282
Author(s):  
Karan Raja ◽  
Nicole Daniel ◽  
Susan Morrison ◽  
Ruben Patel ◽  
Jessica Gerges ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Clinical Status ◽  
Rank Test ◽  
Cytokine Release ◽  
Cytokine Release Syndrome ◽  
Single Center ◽  
Post Dose ◽  
Single Center Experience ◽  
Signed Rank Test ◽  
The Impact

Background: Tocilizumab is an interleukin-6 receptor antagonist hypothesized to blunt the uncontrolled immune response, cytokine release syndrome, in severe COVID-19 and prevent attributable morbidity and mortality. Objective: The objective of this study was to assess the impact of tocilizumab on clinical outcomes in COVID-19-associated cytokine release syndrome. Methods: Single-center, retrospective cohort study assessing sixty-nine adult patients receiving tocilizumab for suspected COVID-19 cytokine release syndrome. The primary outcome was change in WHO clinical status scale on day seven post-dose analyzed using the Wilcoxon signed rank test. Secondary outcomes assessed impact of timing of administration on clinical outcome. Safety analyses included development of neutropenia, thrombocytopenia, transaminitis, and sepsis within 7 days post-dose. Statistical analyses were conducted using Microsoft Excel. Results: No aggregate clinical change was found between day 0 and day 7. Eleven patients improved, twenty-seven worsened, and thirty-one showed no change. Clinical outcomes were weakly correlated with time from symptom onset (rs = 0.21; p = 0.08) or hospital admission (rs = -0.08; p = 0.49) to dose. In-hospital mortality was 63%. Sepsis was diagnosed in 21 patients, five of which were post-dose. Transaminitis, neutropenia, and thrombocytopenia occurred in seven, one, and six patients, respectively. Conclusion: Tocilizumab did not appear to influence clinical outcomes in our study population, irrespective of timing of administration. Adverse events were not considered drug-related.

The Impact of Marijuana Use on Liver Transplant Recipients: A 900 Patient Single Center Experience

2021 ◽  
Author(s):  
Jacob Guorgui ◽  
Takahiro Ito ◽  
Daniela Markovic ◽  
Antony Aziz ◽  
Stephanie Younan ◽  
...  
Keyword(s):  
Liver Transplant ◽  
Marijuana Use ◽  
Transplant Recipients ◽  
Single Center ◽  
Single Center Experience ◽  
Liver Transplant Recipients ◽  
The Impact

Long-term effectiveness and adverse effects of ketogenic diet therapy in infants with drug-resistant epilepsy treated at a single center in Argentina

2021 ◽  
pp. 106793
Author(s):  
Marisa Armeno ◽  
Antonella Verini ◽  
Eugenia Caballero ◽  
Araceli Cresta ◽  
Gabriela Reyes Valenzuela ◽  
...  
Keyword(s):  
Adverse Effects ◽  
Ketogenic Diet ◽  
Diet Therapy ◽  
Drug Resistant ◽  
Single Center ◽  
Drug Resistant Epilepsy

scholarly journals Surgical Outcomes of Early Stage Small Cell Lung Cancer: A Single Center Experience

2019 ◽  
Vol 20 (-1) ◽  
pp. 38-38
Author(s):  
Muhammet Sayan ◽  
◽  
Merve Satir Turk ◽  
Ali Celik ◽  
Ismail Cuneyt Kurul ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Surgical Outcomes ◽  
Early Stage ◽  
Small Cell ◽  
Single Center ◽  
Small Cell Lung ◽  
Single Center Experience

scholarly journals Repeat and Relapsing Peritonitis Microbiological Trends and Outcomes: A 21-Year Single-Center Experience

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Marina Reis ◽  
Catarina Ribeiro ◽  
Ana Marta Gomes ◽  
Clara Santos ◽  
Daniela Lopes ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Catheter Removal ◽  
Control Group ◽  
Single Center ◽  
Cure Rate ◽  
Technique Survival ◽  
Tenckhoff Catheter ◽  
Single Center Experience ◽  
The Impact ◽  
Multiple Episodes

Peritonitis is a major peritoneal dialysis complication. Despite a high cure rate, relapsing and repeat peritonitis is associated with Tenckhoff catheter biofilm and multiple episodes of peritoneal damage. In relapsing peritonitis, prompt catheter removal is mandatory; otherwise, in repeat peritonitis, there is not a clear indication for catheter removal. It is questionable if the approach to removal should be different. There are few recent data on repeat and relapsing peritonitis microbiology and clinical outcomes since most studies are from the past decade. This study evaluates the microbiology, clinical outcomes, and impact of relapsing and repeat peritonitis on technique survival and the impact of catheter removal in development of further peritonitis episodes by the same microorganism. We developed a single-center retrospective study from 1998 to 2019 that compared repeat and relapsing peritonitis with a control group in terms of causative microorganisms, cure rate, catheter removal, and permanent and temporary transfer to hemodialysis. We also compared repeat and relapsing peritonitis clinical outcomes when Tenckhoff catheter was not removed. Comparing to the control group, the repeat/relapsing group had a higher cure rate (80.4% versus 74.5%, p = 0.01 ) and lower rate of hospitalization (10.9% versus 27.7%, p = 0.01 ). Technique survival was superior in the repeat/relapsing group (log rank = 4.5, p = 0.03 ). Gram-positive peritonitis was more common in the repeat/relapsing group especially Streptococci viridans (43.5% versus 21.3%, p = 0.01 ) and Gram-negatives in the control group (26.6% vs 9.0%, p = 0.02 ). When the Tenckhoff catheter was not removed after a repeat episode, 58.6% developed a new repeat/relapsing episode versus 60.0% in the relapsing group. Although repeat and relapsing peritonitis have a higher cure rate, it leads to further episodes of peritonitis and consequent morbidity. When Tenckhoff catheter was not removed, the probability of another peritonitis episode by the same microorganism is similar in repeat and relapsing peritonitis.

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